Short answer: England has no single national record but a national backbone, the Spine, run by NHS England, that every GP practice, hospital, pharmacy and many apps connect to. The Spine provides the Personal Demographics Service (who the patient is, keyed by the NHS number), the Summary Care Record (medications, allergies, adverse reactions from the GP record, with optional additional information), the Electronic Prescription Service, the e-Referral Service and messaging. GP Connect is a set of FHIR APIs that open the full GP record, appointments and documents to other care settings. The NHS App, with NHS login, gives patients their GP record, prescriptions, appointments, test results and hospital letters. Regional Shared Care Records join hospital, GP, social care and community data per area. Suppliers connect through NHS England's API programme after passing the DTAC and the DSPT. Scotland, Wales and Northern Ireland run their own systems.
The national services
The NHS Spine in England provides national services rather than a single record: the Personal Demographics Service keyed by the NHS number, the Summary Care Record, the Electronic Prescription Service, the e-Referral Service, GP Connect FHIR APIs to the GP record, the National Record Locator, MESH file transfer, NHS login and the NHS App as the patient's front door.
| Service | What it does | Technology |
|---|---|---|
| Personal Demographics Service (PDS) | The master index of patients: NHS number, demographics, GP registration, death status | FHIR API (PDS FHIR), older HL7 v3 Spine services |
| Summary Care Record (SCR) | Medications, allergies, adverse reactions from the GP record; additional information (diagnoses, care plans) with consent, now for most patients | HL7 v3 / CDA on Spine; viewed through clinical systems and the National Care Records Service |
| Electronic Prescription Service (EPS) | Prescriptions from GP to the patient's nominated pharmacy; dispensing and claims | Spine messaging; FHIR-based EPS APIs for new suppliers |
| e-Referral Service (e-RS) | GP to hospital referrals and booking | FHIR APIs |
| GP Connect | Access Record HTML and Structured (full GP record), Appointment Management, Send Document, Update Record | FHIR (STU3 and R4 profiles) |
| National Record Locator | Finds documents (care plans, end-of-life plans) held elsewhere | FHIR |
| MESH | Secure file transfer between organisations | Messaging API |
| NHS login | Patient identity at verified levels for apps | OpenID Connect |
| NHS App | The patient's front door: GP record, prescriptions, appointments, results, hospital letters, organ donation, 111 online | Integrates the above; third-party services can be launched from it |
Standards and codes
NHS England's standards are FHIR UK Core as the national FHIR R4 profile set, SNOMED CT mandated across clinical systems, dm+d for medicines, ICD-10 and OPCS-4 for hospital statistics, LOINC in pathology messaging, and the NHS number as universal identifier, with NHS login identity levels deciding what a patient app may show and DAPB information standards carrying legal force.
- FHIR UK Core is the national FHIR R4 profile set; national APIs are moving to it from STU3 and HL7 v3.
- SNOMED CT is mandated across NHS clinical systems; dm+d (the Dictionary of Medicines and Devices) for medicines, mapped to SNOMED CT and ATC; ICD-10 and OPCS-4 for hospital statistics and payment; LOINC is used in pathology messaging alongside the national pathology bounded code list.
- NHS number as the universal identifier; NHS login identity levels P5 (basic) and P9 (verified) decide what a patient app may show.
- Information standards are published as DAPB standards (Data Alliance Partnership Board) with legal force under the Health and Social Care Act.
For suppliers
A supplier connects to NHS England's national services by meeting the DTAC assessment criteria, completing the Data Security and Protection Toolkit, appointing a clinical safety officer under DCB0129, onboarding each API through NHS England's developer portal and its sandbox, integration and production environments, and, where relevant, obtaining medical device status from the MHRA.
- DTAC (Digital Technology Assessment Criteria): the baseline for any digital health product bought by the NHS, covering clinical safety (DCB0129/0160), data protection, technical security, interoperability and usability.
- DSPT (Data Security and Protection Toolkit): the yearly self-assessment every organisation handling NHS patient data must complete.
- Clinical safety: a clinical safety officer and hazard log under DCB0129 (manufacturers) and DCB0160 (deploying organisations).
- API onboarding: NHS England's developer portal (digital.nhs.uk/developer) with sandbox, integration and production environments, and an onboarding process per API (the Supplier Conformance Assessment List, SCAL).
- NHS App integration: services can be surfaced in the App after assessment, using NHS login for identity.
- Medical device status: MHRA regulates software as a medical device under the UK MDR 2002 (based on the former EU directives), with its own route after Brexit; UKCA or recognised CE marking.
The devolved nations
Scotland runs its own national services (the Emergency Care Summary, Clinical Portal, SCI Store, the Digital Front Door programme); Wales has a national architecture (the Welsh Clinical Portal, GP record sharing, the NHS Wales App); Northern Ireland is implementing a single integrated record (encompass). Standards align with SNOMED CT and FHIR but APIs and onboarding are separate from England's.
For a patient
A patient in England uses the NHS App, with NHS login, to see their GP record, prescriptions, appointments, test results and hospital letters, link proxies and manage organ donation, and can download or screenshot entries. Exported records can be kept in a personal record such as Anpheros Daily alongside records from other countries.
The NHS App shows your GP record (including, since 2023, new entries by default for most patients), prescriptions, appointments, results and hospital letters, and lets you link proxies and manage organ donation. You can download or screenshot, and some practices support structured export. A record such as Anpheros Daily can hold what you export, with provenance, next to records from other countries; see Health records online.
National systems change often. This page describes the situation as published by the operators linked under Sources, last reviewed in October 2026; the operator's documentation is the authority for connection requirements.
Related pages
- National electronic health records in Europe and the US
- MyHealth@EU and the cross-border patient summary
- Your medical data in the EU: GDPR, EHDS and your rights
- Health records online: how to access yours in the EU, UK and US
- What is SNOMED CT?
- FHIR implementation guides explained
Sources
- NHS England: API and integration catalogue
- NHS England: GP Connect
- NHS England: Spine
- NHS England: Summary Care Records
- NHS England: NHS login
- NHS England: Digital Technology Assessment Criteria (DTAC)
- NHS England: Data Security and Protection Toolkit
- HL7 UK: UK Core
Frequently asked questions
Does the NHS have one electronic health record?
No. GP records, hospital records and the national Spine services are separate; GP Connect, the Summary Care Record and regional Shared Care Records join them for care, and the NHS App joins them for the patient.
What is the NHS number?
The unique ten-digit identifier for every patient registered with the NHS in England, Wales and the Isle of Man, held in the Personal Demographics Service. Scotland uses the CHI number and Northern Ireland the H&C number.
Can a third-party app read a patient's GP record?
Through NHS App integration or NHS login with the patient's consent, and only for APIs the app has been onboarded to; GP Connect itself is for care settings. Patient-facing structured access is expanding.
Is UK Core the same as US Core?
Both are national FHIR R4 profile sets, built on the same FHIR base with different mandatory elements and terminologies (SNOMED CT and dm+d in the UK). The structure is similar; the content rules are national.
Try it free in the sandbox
Your first FHIR call in 5 minutes. An HL7 FHIR R4 API with the patient's consent built in: try it in the sandbox, then connect your own app or clinic system.
Free · 30 synthetic patients · no card
Anpheros builds a medical record that the patient controls and can share with any clinic, on an HL7 FHIR R4 platform, based in the EU. These guides help you understand and organise your health; they do not replace your doctor.
About Anpheros →
AnpherosThe more you log, the clearer your record
Your health history in one place, under your control.
Free · Works in your browser · No card
